Academic Journal of Engineering and Technology Science, 2025, 8(2); doi: 10.25236/AJETS.2025.080208.
Xu Huang1, Xudong Yu2
1School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
2PLA Naval Medical Center, Naval Medical University, Shanghai, China
The knee exoskeleton is gradually becoming an essential component in people's daily lives, playing a significant role in the fields of rehabilitation and industry. However, the human-machine coupling issue remains a key factor affecting exoskeleton performance. Therefore, this paper provides an overview of the design of the human-machine coupling mechanism for knee exoskeletons. In terms of structural design, the mechanisms are categorized into the simplified fixed-track mechanism, the compliant elastic mechanism, and the self-calibration mechanism, with an analysis of their performance in practical applications. Moreover, this paper discusses the general optimization steps of optimization algorithms and their applications in mechanism optimization. Finally, the challenges currently faced by knee exoskeletons are summarized, and future prospects are proposed.
Knee Exoskeleton; Human-Machine Coupling Mechanism; Mechanism Optimization
Xu Huang, Xudong Yu. Overview of Human-Machine Coupling Mechanism Design for Knee Exoskeletons. Academic Journal of Engineering and Technology Science(2025), Vol. 8, Issue 2: 57-67. https://doi.org/10.25236/AJETS.2025.080208.
[1] Baronchelli F, Zucchella C, Serrao M, et al. The effect of robotic assisted gait training with Lokomat® on balance control after stroke: systematic review and meta-analysis[J]. Frontiers in neurology, 2021, 12: 661815.
[2] Toedtheide A, Chen X, Sadeghian H, et al. A force-sensitive exoskeleton for teleoperation: An application in elderly care robotics[C]//2023 IEEE International Conference on Robotics and Automation (ICRA). IEEE, 2023: 12624-12630.
[3] Cai M, Ji Z, Li Q, et al. Safety evaluation of human–robot collaboration for industrial exoskeleton[J]. Safety science, 2023, 164.
[4] Garosi E, Mazloumi A, Jafari A H, et al. Design and ergonomic assessment of a passive head/neck supporting exoskeleton for overhead work use[J]. Applied Ergonomics, 2022, 101: 103699.
[5] Gull M A, Bai S, Bak T. A review on design of upper limb exoskeletons[J]. Robotics, 2020, 9(1): 16.
[6] Ji X, Wang D, Li P, et al. SIAT-WEXv2: A Wearable Exoskeleton for Reducing Lumbar Load during Lifting Tasks[J]. Complexity, 2020, 2020: 1-12.
[7] Murray S A, Ha K H, Hartigan C, et al. An assistive control approach for a lower-limb exoskeleton to facilitate recovery of walking following stroke[J]. IEEE transactions on neural systems and rehabilitation engineering, 2014, 23(3): 441-449.
[8] Lee H, Ferguson P W, Rosen J. Lower limb exoskeleton systems—overview[J]. Wearable Robotics, 2020: 207-229.
[9] Wang D, Lee K M, Guo J, et al. Adaptive knee joint exoskeleton based on biological geometries[J]. IEEE/ASME Transactions on Mechatronics, 2013, 19(4): 1268-1278.
[10] Ibarra L G, Segura V H, Chávez D, et al. Las enfermedades y traumatismos del sistema músculo esquelético[J]. Un análisis del Instituto Nacional de Rehabilitación de México, como base para su clasificación y prevención, México, Secretaría de Salud, 2013: 147.
[11] Rupal B S, Rafique S, Singla A, et al. Lower-limb exoskeletons: Research trends and regulatory guidelines in medical and non-medical applications[J]. International Journal of Advanced Robotic Systems, 2017, 14(6).
[12] Lee K M, Guo J. Kinematic and dynamic analysis of an anatomically based knee joint[J]. Journal of biomechanics, 2010, 43(7): 1231-1236.
[13] Wismans J A C, Veldpaus F, Janssen J, et al. A three-dimensional mathematical model of the knee-joint[J]. Journal of biomechanics, 1980, 13(8): 677-685.
[14] Wang J, Li X, Huang T H, et al. Comfort-centered design of a lightweight and backdrivable knee exoskeleton[J]. IEEE Robotics and Automation Letters, 2018, 3(4): 4265-4272.
[15] Walker P S, Rovick J S, Robertson D. The effects of knee brace hinge design and placement on joint mechanics[J]. Journal of biomechanics, 1988, 21(11): 965-974.
[16] Iwaki H, Pinskerova V, Freeman M A R. Tibiofemoral movement 1: the shapes and relative movements of the femur and tibia in the unloaded cadaver knee[J]. Journal of Bone and Joint Surgery. British Volume, 2000, 82-B(8): 1189-1195.
[17] Zhang J, Zhu A, Li X, et al. Parallel Elastic Self-Alignment Mechanism Enhances Energy Efficiency and Reduces Misalignment in a Powered Knee Exoskeleton[J]. IEEE Transactions on Biomedical Engineering, 2024.
[18] Suzuki K, Mito G, Kawamoto H, et al. Intention-based walking support for paraplegia patients with robot suit HAL[J]. Advanced Robotics, 2007, 21(12): 1441-1469.
[19] Strausser K A, Swift T A, Zoss A B, et al. Prototype medical exoskeleton for paraplegic mobility: first experimental results[C]//Dynamic Systems and Control Conference: Vol. 44175. 2010: 453-458.
[20] Stienen A H, Hekman E, Van Der Helm F C, et al. Self-aligning exoskeleton axes through decoupling of joint rotations and translations[J]. IEEE Transactions on Robotics, 2009, 25(3): 628-633.
[21] Zhang L, Liu G, Han B, et al. Assistive devices of human knee joint: a review[J]. Robotics and Autonomous Systems, 2020, 125: 103394.
[22] Shiraishi Y. Functional assessment for the natural knee joints in squat activity by simulation of 2D X-ray images based on 3D CT image[J]. Trans Jpn Soc of Mech Eng, 2011, 77: 219.
[23] Walker P S, Kurosawa H, Rovick J S, et al. External knee joint design based on normal motion[J]. J Rehabil Res Dev, 1985, 22(1): 9-22.
[24] Radcliffe C W. Four-bar linkage prosthetic knee mechanisms: Kinematics, alignment and prescription criteria[J]. Prosthetics & Orthotics International, 1994, 18(3): 159-173.
[25] Zavatsky A B, O’Connor J. A Model of Human Knee Ligaments in the Sagittal Plane: Part 1: Response to Passive Flexion[J]. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, 1992, 206(3): 125-134.
[26] Karami M, Maurice G, Andre J M. A model of exo-prosthesis of the knee optimized with respect to the physiological motion of condyles[J]. ITBM-RBM, 2004, 25(3): 176-184.
[27] Bertomeu J M B, Lois J M B, Guillem R B, et al. Development of a hinge compatible with the kinematics of the knee joint[J]. Prosthetics and Orthotics International, 2007, 31(4): 371-383.
[28] Asker A, Xie S, Dehghani-Sanij A. Multi-objective optimization of force transmission quality and joint misalignment of a 5-bar knee exoskeleton[C]//2021 IEEE/ASME international conference on advanced intelligent mechatronics (AIM). IEEE, 2021: 122-127.
[29] Qu X, Chu H, Liu W. Design of A Lower Limb Rehabilitation Training Robot Based on A Double Four-Bar Synchronous Motion Mechanism[C]//International Conference on Intelligent Robotics and Applications. Singapore: Springer Nature Singapore, 2023: 540-551.
[30] Kapsalyamov A, Hussain S, Brown N A, et al. Synthesis of a six-bar mechanism for generating knee and ankle motion trajectories using deep generative neural network[J]. Engineering Applications of Artificial Intelligence, 2023, 117: 105500.
[31] Xiao B, Shao Y, Zhang W. Design and optimization of single-degree-of-freedom six-bar mechanisms for knee joint of lower extremity exoskeleton robot[C]//2019 IEEE International Conference on Robotics and Biomimetics (ROBIO). IEEE, 2019: 2861-2866.
[32] Sabzali H, Koochakzadeh E, Moradi A, et al. Kinematics and dynamics optimization of a novel non-circular gear-attached four-bar mechanism for knee exoskeleton robot[C]//2022 10th RSI International Conference on Robotics and Mechatronics (ICRoM). IEEE, 2022: 190-195.
[33]Sun Y, Ge W, Zheng J, et al. Design and evaluation of a prosthetic knee joint using the geared five-bar mechanism[J]. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 2015, 23(6): 1031-1038.
[34] Wang G, Zhou M, Sun H, et al. Mechanism Analysis and Optimization Design of Exoskeleton Robot with Non-Circular Gear–Pentabar Mechanism[J]. Machines, 2024, 12(5): 351.
[35] Wang Z, Ge W, Zhang Y, et al. Optimization Design and Performance Analysis of a Bionic Knee Joint Based on the Geared Five-Bar Mechanism[J]. Bioengineering, 2023, 10(5): 582.
[36] Olinski M. Knee joint prototype based on cam mechanism – design and video analysis[J]. Computer Methods in Biomechanics and Biomedical Engineering, 2023, 26(14): 1691-1701.
[37] Arfaie O, Unal R. KnExo, design, development, and functional evaluation of a bio-joint shaped knee exoskeleton assisting in sit to stand[J]. Authorea Preprints, 2024.
[38] Soong R C. A new cam-geared mechanism for exact path generation[J]. Journal of Advanced Mechanical Design, Systems, and Manufacturing, 2015, 9(2): JAMDSM0020-JAMDSM0020.
[39] Kim T, Jeong M, Kong K. Bioinspired knee joint of a lower-limb exoskeleton for misalignment reduction[J]. IEEE/ASME Transactions on Mechatronics, 2021, 27(3): 1223-1232.
[40] Liu Z, Han J, Han J, et al. Design and Evaluation of a Lightweight, Ligaments-Inspired Knee Exoskeleton for Walking Assistance[J]. IEEE Robotics and Automation Letters, 2024.
[41] Wang Y, Zhang W, Shi D, et al. Design and control of an adaptive knee joint exoskeleton mechanism with buffering function[J]. Sensors, 2021, 21(24): 8390.
[42] Zhao Han, Wang Bing, Yang Yuwei, et al. Research on Adaptive Variable Stiffness Load Optimization of Knee Exoskeleton Robot [J]. High Technology Letters, 2022, 32(1): 93-100.
[43] Yang Canjun, Peng Zhenzhe, Xu Linghui, et al. Design of a Flexible Knee Joint Protective Exoskeleton and Its Walking Assistance Method [J]. Journal of Zhejiang University (Engineering Science), 2021, 55(2).
[44] Sridar S, Qiao Z, Muthukrishnan N, et al. A soft-inflatable exosuit for knee rehabilitation: Assisting swing phase during walking[J]. Frontiers in Robotics and AI, 2018, 5: 44.
[45] Fang J, Yuan J, Wang M, et al. Novel Accordion-Inspired Foldable Pneumatic Actuators for Knee Assistive Devices[J]. Soft Robotics, 2020, 7(1): 95-108.
[46] Panizzolo F A, Galiana I, Asbeck A T, et al. A biologically-inspired multi-joint soft exosuit that can reduce the energy cost of loaded walking[J]. Journal of NeuroEngineering and Rehabilitation, 2016, 13(1): 43.
[47] Di Natali C, Poliero T, Sposito M, et al. Design and evaluation of a soft assistive lower limb exoskeleton[J]. Robotica, 2019, 37(12): 2014-2034.
[48] Celebi B, Yalcin M, Patoglu V. AssistOn-Knee: A self-aligning knee exoskeleton[C]//2013 IEEE/RSJ international conference on intelligent robots and systems. IEEE, 2013: 996-1002.
[49]Choi B, Lee Y, Kim J, et al. A self-aligning knee joint for walking assistance devices[C]//2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC). IEEE, 2016: 2222-2227.
[50] Sarkisian S V, Ishmael M K, Hunt G R, et al. Design, development, and validation of a self-aligning mechanism for high-torque powered knee exoskeletons[J]. IEEE Transactions on Medical Robotics and Bionics, 2020, 2(2): 248-259.
[51] A method for analyzing wearing uncertainties and enhancing motion transmission smoothness in exoskeletons and its applications for a novel passive knee exoskeleton[J]. Mechanism and Machine Theory, 2024, 197: 105648.
[52] Li G, Liang X, Lu H, et al. Development and validation of a self-aligning knee exoskeleton with hip rotation capability[J]. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 2024, 32: 472-481.
[53] Choi B, Lee Y, Lee J, et al. Development of adjustable knee assist device for wearable robot based on linkage and rolling joint[C]//2019 IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS). IEEE, 2019: 4043-4050.
[54] Li H, Sui D, Ju H, et al. Mechanical compliance and dynamic load isolation design of lower limb exoskeleton for locomotion assistance[J]. IEEE/ASME Transactions on Mechatronics, 2022, 27(6): 5392-5402.
[55] Yang X, Guo S, Wang P, et al. Design and Optimization Analysis of an Adaptive Knee Exoskeleton[J]. Chinese Journal of Mechanical Engineering, 2024, 37(1): 104.
[56] Wen Yaoqi, Yang Yuwei, Zu Yizhou, et al. Performance Optimization and Methodology of a Knee Exoskeleton Robot Donning System Considering Comfort [J]. Journal of Biomedical Engineering, 2023, 40(1): 118.
[57] Zhang Junhui, Pan Zhiwen, Jia Ruiheng, et al. Optimization Method for Upper Limb Exoskeleton Master-Slave Control of Hydraulic Manipulator Based on Human-Machine Matching: CN118061156B [P]. 2024-08-23.